A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

Double the dose if a dose is missed.

Reduce caffeine and acidic intake.

Avoid taking on an empty stomach.

Consume 2. liters of water daily.

Answer and Explanation

The Correct Answer is A

A. Double the dose if a dose is missed:
This instruction is incorrect. Clients should not double their dose of allopurinol if they miss a dose. Instead, they should take the missed dose as soon as they remember, unless it is almost time for the next dose. Doubling the dose can lead to overdose and potential side effects.

B. Reduce caffeine and acidic intake:
Reducing caffeine and acidic foods can help manage gout and lower uric acid levels, making this advice appropriate.

C. Avoid taking on an empty stomach:
While allopurinol can be taken with or without food, some clients might find it less irritating if taken with food. This guidance is intended to reduce gastrointestinal discomfort.

D. Consume 2 liters of water daily:
Drinking adequate fluids helps prevent kidney stones and promotes overall kidney health, which is especially important when taking allopurinol. This advice supports effective medication use and overall health.

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Correct Answer is C

Explanation

A. Digoxin level of 1.1 ng/mL (1.4 nmol/L):
A digoxin level of 1.1 ng/mL is within the therapeutic range (0.8 to 2.0 ng/mL). While it is important to monitor digoxin levels, this value does not indicate an immediate concern.

B. Creatinine level of 0.8 mg/dL (70.72 μmol/L):
A creatinine level of 0.8 mg/dL is within the normal range (0.5 to 1.1 mg/dL) and does not indicate any renal impairment or immediate issue.

C. Potassium level of 3.2 mEq/L (3.2 mmol/L):
A potassium level of 3.2 mEq/L is below the normal range (3.5 to 5.0 mEq/L). Hypokalemia can increase the risk of digoxin toxicity and arrhythmias, making this an urgent issue that should be reported to the healthcare provider immediately.

D. Sodium level of 135 mEq/L (135 mmol/L):
A sodium level of 135 mEq/L is slightly below the normal range (136 to 145 mEq/L), but it is not as critical as a significantly abnormal potassium level in the context of digoxin use. While it should be monitored, it is less urgent compared to the potassium level.

A. Migraine headaches. B. Chronic alcoholism. C. Osteoarthritis. D. Type 2 diabetes mellitus.

Correct Answer is B

Explanation

A) Migraine headaches: While migraine headaches are significant for overall health management, they are less directly related to the risks associated with NSAID use compared to other conditions. Migraines do not typically influence the safety profile of NSAIDs.

B) Chronic alcoholism: Chronic alcoholism is a major concern because it significantly increases the risk of gastrointestinal complications with NSAID use. NSAIDs can cause gastric irritation, bleeding, and ulcers, and alcohol can exacerbate these risks, leading to severe gastrointestinal issues or liver damage.

C) Osteoarthritis: Osteoarthritis is a common indication for NSAID use and, therefore, does not pose an additional risk specific to the medication. NSAIDs are often prescribed to manage pain and inflammation associated with osteoarthritis.

D) Type 2 diabetes mellitus: Although diabetes mellitus requires careful management, it does not directly increase the risk of NSAID-related complications. However, clients with diabetes need to be monitored for overall health and medication effects, but chronic alcoholism poses a more immediate risk for NSAID use.

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A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

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Correct Answer is C

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